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Grounded in extensive research and clinical experience, this book describes how to adapt mindfulness-based cognitive therapy (MBCT) for participants who struggle with recurrent suicidal thoughts and impulses. Relevant to all mindfulness teachers, a comprehensive framework is presented for understanding suicidality and its underlying vulnerabilities. The preliminary intake interview and each of the eight group mindfulness sessions of MBCT are discussed in detail, highlighting issues that need to be taken into account with highly vulnerable people. Assessment guidelines are provided and strategies for safely teaching core mindfulness practices are illustrated with extensive case examples. The book also discusses how to develop the required mindfulness teacher skills and competencies. Purchasers get access to a companion website featuring downloadable audio recordings of the guided mindfulness practices, narrated by Zindel Segal, Mark Williams, and John Teasdale.

See also Mindfulness-Based Cognitive Therapy for Depression, Second Edition, by Zindel Segal, Mark Williams, and John Teasdale, the authoritative presentation of MBCT.

1. Introduction I. Theoretical and Research Background 2. The Origins of Despair: An Evolutionary Perspective 3. Why the Idea of Suicide Won''t Let Go 4. How Could Mindfulness Help?: Doing and Being II. MBCT for Those at Risk of Suicide 5. Assessing Vulnerability to Depression and Suicidality 6. Developing the Preclass Interview: Encouraging Vulnerable Participants to Engage in and Persist with Mindfulness Meditation 7. Session 1: Awareness and Automatic Pilot 8. Session 2: Living in Our Heads 9. Session 3: Gathering the Scattered Mind 10. Session 4: Recognizing Aversion 11. Session 5: Allowing/Letting Be 12. Session 6: Thoughts Are Not Facts 13. Session 7: How Can I Best Take Care of Myself? 14. Session 8: Maintaining and Extending New Learning 15. How Does MBCT Enable Transformation?: Jane''s Story III. Training Teachers and Defining Competence 16. MBCT Teaching Integrity: Assessing Mindfulness-Based Teaching Skills 17. The Experience of Being an MBCT Teacher IV. MBCT--The Results 18. Mindfulness on Trial: Does MBCT Help People at Risk of Suicide? Further Reading and Resources References

"The book is the culmination of an ambitious decade-long effort to develop and refine an effective treatment for the subgroup of depressed patients who are most susceptible to suicidal behavior--those with histories of early maltreatment, an early onset, recurrent episodes, and incomplete recovery. The authors comprehensively present their adaptation of MBCT, provide guidelines for training and supervision, and summarize the results of a recent clinical trial. This is useful and fascinating material for clinicians treating this highly challenging group of patients."--Daniel N. Klein, PhD, Department of Psychology, Stony Brook University

"MBCT has established an admirable track record for preventing relapse into depression. But can a program based on mindfulness meditation be safely applied to people suffering from vulnerability to suicide? The authors take us on a scholarly and compassionate journey that lasted over a decade, pointing out the specific adaptations they made to the MBCT program and why. This book represents an important advance for mindfulness-based psychotherapy, an impressive model for how to develop an evidence-based treatment, and a rich resource for anyone who wishes to understand and treat the dilemma of suicide."--Christopher K. Germer, PhD, private practice, Arlington, Massachusetts

"This book examines despair and suicidality with a keen eye. It is a beautiful illustration of how to bring astute observation to an important clinical problem and develop and test a theory-based intervention. The authors present an innovative adaptation of MBCT that helps individuals uncouple suicidality from depressed mood, decrease cognitive reactivity and suicidal thinking, and increase awareness and self-compassion. Importantly, their research demonstrates the particular effectiveness of this approach for the most vulnerable, those who experienced childhood trauma."--Stuart J. Eisendrath, MD, Director, UCSF Depression Center, University of California, San Francisco

"Taking up a sensitive and painful topic, this book lays out a comprehensive course for helping suicidal patients using MBCT. Williams et al. explain suicidality through evolutionary logic and grapple directly with the most treacherous aspects of working with this population. The authors argue that MBCT helps to make autobiographical memories more specific, thus addressing a crucial vulnerability factor in suicidality. The volume covers a lot of ground. It provides multiple mindfulness and movement exercises aimed to reduce suicidal thoughts and restore patients on a path of well-being."--Elliot L. Jurist, PhD, Professor of Psychology and Philosophy, The Graduate Center and The City College of New York, The City University of New York

“Extremely accessible, informative, and engaging, this outstanding book is a 'must read' for anyone with an interest in understanding suicidal despair and its treatment. It is unusual in a single volume to find such a comprehensive description of the science of suicide risk as well as a detailed overview of how to adapt and implement MBCT. The inclusion of the case studies, such as 'Jane's story,' is really helpful."--Rory C. O’Connor, PhD, Director, Suicidal Behaviour Research Laboratory, University of Glasgow, United Kingdom

"The authors describe their work with clients who need the best help possible, but who are often excluded from research trials and treatment programs. They discuss how they sensitively adapted the MBCT program to address such problems as the originally high dropout rate of people at the highest risk of suicide. The reward is clear: those who are most vulnerable do best with this adapted version of MBCT, compared to treatment as usual and psychoeducation. I truly hope this program becomes available to all who need it."--Susan Bögels, PhD, Department of Medical, Clinical, and Experimental Psychology, University of Amsterdam, The Netherlands

J. Mark G. Williams, DPhil, is Emeritus Professor of Clinical Psychology at the University of Oxford, where he was Wellcome Principal Research Fellow from 2003 to 2012. He collaborated with John Teasdale and Zindel Segal in developing mindfulness-based cognitive therapy (MBCT) to prevent relapse and recurrence in major depression; together, they coauthored Mindfulness-Based Cognitive Therapy for Depression (now in its second edition), The Mindful Way Workbook, and (with Jon Kabat-Zinn), The Mindful Way through Depression. Dr. Williams is a Fellow of the Academy of Medical Sciences and the British Academy. Now retired, he continues to train mindfulness teachers around the world.

Melanie Fennell, PhD, is a Founding Fellow of the Oxford Cognitive Therapy Centre, where she is now an Associate Trainer. She is also an Associate Trainer at the Oxford Mindfulness Centre. As a research clinician in the University of Oxford Department of Psychiatry, she contributed to the development of evidence-based treatments for depression and anxiety disorders, including MBCT. She developed and led the Oxford Diploma in Cognitive Therapy, the Oxford Diploma/MSc in Advanced Cognitive Therapy Studies, and (with Mark Williams) the Oxford Master of Studies program in Mindfulness-Based Cognitive Therapy. Dr. Fennell is an Honorary Fellow of the British Association of Behavioural and Cognitive Psychotherapies (BABCP) and was voted “Most Influential Female UK Cognitive Therapist” by the BABCP's membership in 2002.

Thorsten Barnhofer, PhD, is a Heisenberg Fellow at Charité, the joint medical faculty of the Free University of Berlin and Humboldt University, where he investigates the neural mechanisms of mindfulness training in the treatment and prevention of depression. Previously, he worked in Professor Williams’s group at the Oxford Department of Psychiatry, where he was involved in research on MBCT for suicidal and chronic depression. A cognitive-behavioral therapist and yoga teacher, Dr. Barnhofer regularly teaches MBCT training workshops and retreats for mental health professionals.

Rebecca Crane, PhD, MA, DipCot, is Director of the Centre for Mindfulness Research and Practice at Bangor University in Wales. She previously worked in the mental health field as an occupational therapist and an integrative counsellor. Dr. Crane teaches and trains internationally in both MBCT and mindfulness-based stress reduction (MBSR), and is a certified MBSR teacher with the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School.

Sarah Silverton, DipCot, MEd, teaches at the Centre for Mindfulness Research and Practice at Bangor University, Wales. She has extensive experience as an occupational therapist, counselor, and mindfulness teacher and trainer. She is the author of The Mindfulness Breakthrough.